[1]梁四妥,张西宁,庞彦英,等.氯替泼诺联合环孢素滴眼液治疗干燥综合征型干眼的疗效观察[J].眼科新进展,2014,34(11):1073-1076.[doi:10.13389/j.cnki.rao.2014.0298]
　LIANG Si-Tuo,ZHANG Xi-Ning,PANG Yan-Ying,et al.Loteprednol Etabonate ophthalmic suspension with cyclosporine eye drops for dry eye of Sjogren ’ s syndrome[J].Recent Advances in Ophthalmology,2014,34(11):1073-1076.[doi:10.13389/j.cnki.rao.2014.0298]
点击复制

氯替泼诺联合环孢素滴眼液治疗干燥综合征型干眼的疗效观察
分享到：

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
34卷
期数:
2014年11期
页码:
1073-1076
栏目:
应用研究
出版日期:
2014-11-05

文章信息/Info

Title:
Loteprednol Etabonate ophthalmic suspension with cyclosporine eye drops for dry eye of Sjogren ’ s syndrome
作者:
梁四妥; 张西宁; 庞彦英; 韩二杰
061000　河北省沧州市，沧州眼科医院眼科
Author(s):
LIANG Si-Tuo ; ZHANG Xi-Ning ;  PANG Yan-Ying ;  HAN Er-Jie
关键词:
氯替泼诺; 环孢素; 干燥综合征; 干眼
Keywords:
Loteprednol ;  cyclosporine ;  Sjogren ’ s syndrome ;  dry eye
DOI:
10.13389/j.cnki.rao.2014.0298
文献标志码:
A
摘要:
目的　观察局部使用５ｇ?Ｌ－１氯替泼诺滴眼液联合１０ｇ?Ｌ－１环孢素滴眼液治疗中重度干眼的安全性与疗效。方法　２０１３年１月至２０１４年１月，于我院门诊收集中重度干眼患者３２例（６４）眼，１ｇ?Ｌ－１玻璃酸钠滴眼液每天４～８次作为基础用药，随机分为两组：试验组１７例（３４眼），予以５ｇ?Ｌ－１氯替泼诺滴眼液滴眼，２周后改为５ｇ?Ｌ－１氯替泼诺滴眼液联合１０ｇ?Ｌ－１环孢素滴眼液滴眼；对照组１５例（３０眼），予以５ｇ?Ｌ－１氯替泼诺滴眼液滴眼。在治疗前及治疗后２、４、６、８周进行干眼症状问卷调查，行裂隙灯、泪膜破裂时间（ｂｒｅａｋ-ｕｐｔｉｍｅ，ＢＵＴ）、角膜荧光素染色（ｆｌｕｏｒｅｓｃｅｎｔｓｔａｉｎｉｎｇ，ＦＬ）、ＳｃｈｉｒｍｅｒＩ试验（ＳｃｈｉｒｍｅｒＩｔｅｓｔ，ＳＩＴ）及非接触式眼压检查（ｎｏｎ-ｃｏｎｔａｃｔｉｎｔｒａｏｃｕｌａｒｐｒｅｓｓｕｒｅｍｅａｓｕｒｅｍｅｎｔ，ＮＣＴ）等。并对数据进行统计学分析。结果　两组患者治疗后２周、４周、６周、８周主观症状评分及ＦＬ评分均较治疗前明显降低，差异均有统计学意义（均为Ｐ＜００５）。治疗后４周、６周，对照组主观症状评分明显低于试验组，差异均有统计学意义（Ｐ＝０．０００、０．０２１），但治疗后８周，两组间差异无统计学意义（Ｐ＝０．６１１）。治疗后６周对照组ＢＵＴ较治疗前延长（Ｐ＜０．０５），治疗后８周两组ＢＵＴ均较治疗前延长（Ｐ＜０．０５），各时间点两组间ＢＵＴ差异均无统计学意义（均为Ｐ＞０．０５）。两组各时间点的ＳＩＴ和ＮＣＴ值较治疗前均无明显变化（均为Ｐ＞０．０５），各时间点组间差异均无统计学意义（均为Ｐ＞０．０５）。结论　对于中重度干燥综合征型干眼等慢性干眼患者采用局部５ｇ?Ｌ－１氯替泼诺滴眼液预处理有助于减轻１０ｇ?Ｌ－１环孢素滴眼液所产生的刺痛，安全有效，又可避免长期应用其他类激素可能产生的不良反应。
Abstract:
Objective To observe the efficacy and safety of 5 g . L-l Loteprednol Etabonate ophthalmic suspension with 10 g ’ L-l cyclosporine eye drops in the treatment of moderate and severe dry eye of Sjogren ’ s syndrome. Methods From January 2013 to January 2014 ,totally 32 dry eye patients( 64 eyes) in grade 2 0r grade 3 of Sjogren ’ s syndrome in our hospital were enrolled,l g . L-l sodium hyaluronate eye drops 4 - 8 times everyday was as the basis for medication.were randomly divided into two groups : In the experimental group ( 17 patients , 34 eyes ) , 5 g . L -1 loteprednol ophthalmic suspension was applied,5 g . L -1 loteprednol ophthalmic suspension combined with 10 g . L -l cyclosporine eye drops( bid) were applied 2 weeks later;ln the control group(15 cases.30 eyes) ,5 g ’ L-l loteprednol ophthalmic suspension was applied. Questionnaire was used in these patients before the treatment and repeated every 2 weeks during the treatment till 8 weeks. Slit lamp microscope exanunation . tear breakup time( BUT) .fluorescent staining ( FL) , Schirmer I test( SIt) and intraocular pressure measurement were carried out at the same time point. t test was used for statistical analysis. ReSHlts After 2 weeks ,4 weeks .6 weeks.8 weeks of the treatment.the mean scores of subjective symptom and FL were sigruficantly lower than those before the treatment in each group ( all P < 0. 05 ) . After 4 weeks.6 weeks of the treatment, the mean scores of subjective symptom were significantly lower in the control group than the experimental group (P = 0. 000 .0. 021 ) , but there was no significant difference between the two groups after 8 weeks of the treatment(P = 0. 611). After 6 weeks of the treatment.BUT was significantly prolonged in the control group compared with pretreatment ( P < 0. 05 ) . After 8 weeks . BUT was significantly prolonged in each group after the treatment ( P < 0. 05 ) . there was no significant difference between the two groups( all P > 0. 05 ) . There was no statistical difference in SIT and non-contact intraocular pressure between pre-treatment and post-treatment of two groups ( all P > 0. 05 ) . and no difference was also found at different time between two groups( all P > 0. 05) . Conclusion For chronic moderate to severe dry eye, such as Sjogren’ s syndrome patients, using topical 5 g . L-l loteprednol ophthalmic suspension in pre-treatment can reduce the stabbing pain produced by 10 g . L -l cyclosporine eye drops,is safe and effective , and also avoid adverse reactions produced by other hormones long-term application.
更新日期/Last Update: 2014-11-11